Finding Agency in Mental Illness

The importance of free choice for recovery

Image by Free-Photos from Pixabay

Agency is a sociological construct that refers to the capacity to freely make decisions and then independently enact those decisions. Agency can be limited by our own individual beliefs, and it can also be limited by social structures that impose rules and constraints.

Structural constraints imposed on people living with mental illness can come from power structures within the psychiatric system, the illness itself, and the associated diagnostic labels.

According to a paper by Lysaker & Leonhardt, agency in mental illness recovery can involve creating meanings, asserting personal rights, and having a sense of ownership over one’s own thoughts, feelings, and actions. It can also mean being able to create and tell one’s own story. The authors wrote: “To be an agent is the result of the recognition and basic experience one has at an elemental bodily level which can be shared with and understood by other people.”

When I started blogging almost two years ago, I was at a real low point in terms of agency. Between my illness and the impact of external circumstances, I felt like I had very little control and a very limited capacity to effect change. [Word of the day note: “effect” used as a verb means “to bring about”, and this is perhaps the first time I’ve ever used it in a sentence] I felt like I had been actively and repeatedly silenced.

Blogging allowed me to tell me story. In the process of telling, it gave me a greater sense of control and ownership. My illness is still present, and it still knocks me on my ass sometimes, but blogging has allowed for a sense of agency that brings the concept of recovery closer to within reach.

It also helps that my key treatment provider, my GP, allows me to be very much in the driver’s seat. A large part of my experience historically with psychiatric care has involved the imposition of structure that boxed me into a corner and stripped me of power. I don’t want to go back to that.

When the system takes away agency, it deprives those of us caught within it of the ability to create change that promotes our own recovery.

When people try to silence us, that also reduces our agency and correspondingly reduces our ability to heal.

So let’s keep talking.


Originally published at on August 5, 2019.

Written by

Mental health blogger | MH Nurse | Living with depression | Author of 3 books, latest is Managing the Depression Puzzle |

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